Gender-affirming care improves mental health for transgender and nonbinary people

On February 23, 2022, Texas governor Greg Abbott told the Texas Department of Family and Protective Services to conduct thorough investigations into any reports of minors undergoing elective gender confirmation procedures and called for Texans to report incidences of children receiving gender-affirming care. A day earlier the state’s Attorney General issued an opinion that equated care such as puberty blockers to child abuse. Much of the public furor against the actions of Texas state officials centered on how the actions would impact the mental health of gender diverse children. A new report examines how receiving gender-affirming care impacts the mental health of transgender and nonbinary adolescents and young adults, who are often at risk of suboptimal mental health outcomes due to discrimination and stigma.¹

The investigators performed a prospective observational cohort study at an urban multidisciplinary gender clinic. The participants were transgender or nonbinary individuals who were seeking gender-affirming care. They used the Patient Health Questionnaire 9-item (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7) scales to assess mental health outcomes.

A total of 104 adolescents and young adults aged 13 to 20 years participated in the study: 63 transmasculine, 27 transfeminine, 10 nonbinary or gender fluid, and 4 who either did not respond to the gender identity question or responded, “I don’t know.” At the study’s baseline, 59 were found to have moderate or severe depression; 52 had moderate to severe anxiety; and 45 indicated engaging in self harm of having thoughts of suicide. By the time the study ended, 69 had been given puberty blockers, gender-affirming hormones, or both, whereas 35 hadn’t received either intervention. After adjusting for both potential confounders and temporal trends, the investigators found that the participants who had started either intervention had 60% lower odds of depression and 73% lower odds of suicidality than among those who had not been given gender-affirming care. No link between receiving puberty blockers or gender-affirming hormones and anxiety were discovered.

The investigators concluded that receiving gender-affirming medical interventions were linked to lowered risks for negative mental health outcomes over the course of 12 months. The results contribute to a growing collection of evidence that indicates that gender-affirming care is linked to overall improved well-being to transgender and nonbinary teenagers and young adults.

Reference

1. Tordoff D, Wanta J, Collin A, Stepney C, Inwards-Breland D, Ahrens K. Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care. JAMA Netw Open. 2022;5(2):e220978. doi:10.1001/jamanetworkopen.2022.0978